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Volume 44, Issue 7
Displaying 1-11 of 11 articles from this issue
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Tadaaki Miyamoto2004 Volume 44 Issue 7 Pages 741-751
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt has been more than one decade since we started carbon beam therapy for lung cancer using the heavy ion medical accelerator in Chiba (HIMAC) in November 1994. Recently, this therapy for clinical stage I non-small cell lung cancer achieved a local control rate of more than 95%, 5-year overall survival rate of 50-60% and causespecific survival rate of 70-80%. These results were equal to those by surgery. Throughout the 10 years, the treatment period and fractionation shortened and lessened from 18 fractions over 6 weeks to 9 fractions over 3 weeks and further to 4 fractions over one week. Finally it reached a single-dose. Presently, 46 patients were already treated with a single dose since April 2003 and this therapy is demonstrating low morbidity and high QOL. Single-dose irradiation is carbon beam radiosurgery. This therapy could be a promising therapeutic modality against lung cancer in the future.View full abstractDownload PDF (5697K) -
Yasuhiko Ohta, Masaya Tamura, Kenji Iino, Yoshio Tsunezuka, Kanae Nitt ...2004 Volume 44 Issue 7 Pages 753-758
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. For successful intrapleural chemotherapy, efforts should be made to maintain the intrapleural drug activity as long as possible. In this interim report, the effectiveness of paclitaxel administered by 24-hour intrathoracic infusion as an adjunct to selective surgical management and/or systemic chemotherapy for controlling malignant pleural effusions is described. Methods. Between October 2001 and May 2004, 10 patients with carcinomatous pleuritis were enrolled in the study. The primary sites of the diseases were the lung in 9 patients and the breast in one patient. Paclitaxel (120 mg/m2) was administered by 24-hour intrathoracic infusion. Six of the 10 patients selectively underwent surgical treatment and 9 patients received adjuvant systemic chemotherapy. The operative procedures used were partial resection of the primary site plus parietal pleurectomy (PL) in 2 cases, lobectomy plus PL in 2 cases, PL only in one case, and chest wall resection plus PL in one case. Results. In patients who underwent surgery, the mean time interval between the operation and intrapleural chemotherapy was 7.7 days (range 3-16 days). Mild toxicity was found in 5 cases, and chest pain and neutropenia were dominant. During a median follow-up period of 19 months (range, 3-33 months), malignant effusions were successfully controlled in 8 patients and the median survival period was 18 months. Conclusion. The use of paclitaxel in this manner merits further investigation for possible intervention for malignant pleural effusions originating in lung and breast neoplasms.View full abstractDownload PDF (1025K) -
Mantaro Kodate, Toshihiro Osaki, Manabu Yasuda, Masakazu Sugaya, Mitsu ...2004 Volume 44 Issue 7 Pages 759-762
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. To examine the characteristics of resected lung cancer patients in whom bronchial stump invasion was recognized microscopically. Methods. Among 776 patients with lung cancer who had undergone surgery, we studied 20 patients, whose bronchial stump showed microscopic infiltration by carcinoma cells. Results. In 13 patients, residual carcinoma was detected only in the bronchial stump, while in 7 lesions were also detected at other sites (five in other organs, and 2 in metastatic lymph nodes). Microscopically, residual cancer was detected within the epithelial layer in two patients, intrabronchial tissue in 6, and extrabronchial in 12. Vascular invasion was detected in 10 cases. Patients without residual tumor other than the bronchial stump had a good outcome. All 10 patients with vascular invasion had lymph node metastasis, 8 of which developed distant metastasis and all 10 died. Conclusion. Patients whose residual carcinoma invaded no more than the bronchial epithelial layer, without vascular invasion, may have a good outcome after postoperative irradiationView full abstractDownload PDF (630K) -
Yuji Saito, Makoto Odaka, Shuji Sato, Tadashi Akiba, Yoji Yamazaki, To ...2004 Volume 44 Issue 7 Pages 763-766
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. Recently several cases of malignant tumor, especially lung cancer, associated with dermatomyositis are reported. Therefore we studied resected and autopsied cases of lung cancer associated with dermatomyositis in the Jikei University School of Medicine. Methods. We clinicopathologically investigated 2 cases (0.6%) associated with dermatomyositis in 313 lung cancer patients undergoing lung resection from January 1997 through May 2003. Further, we also clinicopathologically investigated 2 lung cancer cases (16.7%) in 12 autopsied patients associated with dermatomyositis from 1976 through 2003. Results. Two cases, who were 68 and 78-year-old men, underwent resection in 2003. Their histopathological findings revealed moderately to poorly differentiated squamous cell carcinoma and moderately differentiated adenocarcinoma, respectively. Six cases of 12 autopsied patients with dermatomyositis were associated with cancer, and 2 cases (33%) of them were associated with lung cancer. They were 77 and 65-yearold men and were autopsied in 1995 and in 2002 respectively. Their histopathological findings revealed large cell carcinoma and small cell carcinoma. Conclusion. Four cases with lung cancer had pathological findings, however all of them were elderly men and they underwent resection or autopsy recently. In elderly male patients with dermatomyositis, not only cancer of the digestive organs but lung cancer should be considered as a critical frequently associated disease.View full abstractDownload PDF (568K) -
Eiki Mizutani, Hidenori Inoue, Hirochika Matsubara, Kentaro Kamiya, Sa ...2004 Volume 44 Issue 7 Pages 767-771
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. The staging of lymph node metastasis is an important factor affecting the treatment and prognosis of human lung cancer. As an aid for research on lymph node metastasis and remedy for metastatic lymph nodes, we tried to devise a more useful animal model. Methods. RERF-LC-AT (human lung squamous cell carcinoma) cells were injected subcutaneously into the foot pad of male nude rats after the animals had been irradiated. We considered their inguinal lymph nodes to contain metastases when the nodes became palpable through the skin surface. Two weeks later, the rats were sacrificed and their popliteal and inguinal lymph nodes were removed for histological examination. Results. The time required for metastatic lymph nodes to become palpable was 41.1 ± 4.1 days (n=20). Metastasis to popliteal lymph nodes was found in 100% of cases (n=20) and histopathological study showed invasion of the tumor cells into the cortex and medulla, occupying over one half of the node. Metastasis to inguinal lymph nodes was confirmed in 95.0% of the cases (n=20). Histopathological study showed that tumor cells occupied over one half of the node in all cases, except in one rat that was sacrificed at an early point. Conclusions. We conclude that the present model of primary and secondary lymph node metastasis, involving subcutaneous implantation of human lung cancer cells in the foot pad of nude rats, is useful for producing popliteal and inguinal lymph node metastases. Metastasis of the tumor cells occurred at a high rate, and the determination of metastasis was easy and accurate.View full abstractDownload PDF (2724K) -
Kazutoshi Komiya, Naoko Sueoka, Tomomi Nakamura, Toru Sakuragi, Yukino ...2004 Volume 44 Issue 7 Pages 773-777
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Benign metastasizing leiomyoma (BML) is a rare entity among leiomyomas in the lung. Most cases had previously undergone hysterectomy for uterine leiomyoma, but the pathogenesis and biology have not been elucidated yet. In this paper, we report a case of BML found 10 years after hysterectomy along with the results of immunohistochemical analyses of both the lung nodule and uterine tissue specimens. Case. A 53-year-old woman was found to have an abnormal shadow on a chest X-ray film and was referred to our hospital for further evaluation. Chest CT scan showed multiple smoothly marginated nodules 3 to 18 mm in diameter in bilateral lung fields. Although metastatic lung cancer was suspected, no primary lesion was detected. Thoracoscopic lung biopsy was performed, and the diagnosis of BML was made histopathologically. To attempt to clarify the pathogenesis of BML, immunohistochemical analyses of estrogen receptor (ER), progesterone receptor (PgR), p53, Bcl-2, and Ki-67 of both lung nodules and uterus tissue specimens were performed. Both tissues stained positively for ER, PgR, and Bcl-2, but both were negative for p53 and Ki-67. Conclusion. Immunohistochemical analyses revealed similar results from both the lung nodule and uterus tissue. In particular, ER and PgR were positive in both tissues, suggesting a role of sex hormones in the pathogenesis of BML. Although BML is rare, it should be considered as a possible differential diagnosis when multiple nodules occur within the lung associated with a history of uterine leiomyoma.View full abstractDownload PDF (3543K) -
Kikuo Nakano, Kenbu Nakamoto, Michinori Yamamoto, Kenichi Omori, Yoshi ...2004 Volume 44 Issue 7 Pages 779-784
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Despite radical multimodality therapy to improve local control, the large majority of patients with malignant pleural mesothelioma die of locoregional failure. We report two cases of malignant pleural mesothelioma treated with chemotherapy plus concurrent high-dose hemithoracic radiation after extrapleural pneumonectomy. Cases. 50-and 60-year-old man were diagnosed as having epithelial cell type of right-sided malignant pleural mesothelioma, clinical stage I. They were treated with chemoradiotherapy consisting of cisplatin (6mg/m2 every day), vindesine (3mg/m2 once weekly), and concurrent hemithoracic radiation (50 Gy) two months after extrapleural pneumonectomy. Two patients developed only treatment-related toxicities of grade 3 or greater neutropenia during the chemoradiation phase and no discontinuation of treatment. They had positive resection margins, however, no local failure inside of the radiation field. The one is alive with recurrent disease outside the radiation field for twenty two months since the operation. The other died due to bacterial pneumonia ten months after the operation. Conclusion. Extrapleu-ral pneumonectomy followed by chemotherapy plus concurrent high-dose hemithoracic radiation is a feasible multimodality therapy to improve local control for patients with malignant pleural mesothelioma.View full abstractDownload PDF (3744K) -
Akitoshi Saito, Katsura Ozawa, Masahisa Miyazawa2004 Volume 44 Issue 7 Pages 785-789
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. It is difficult to diagnose lung carcinomas associated pulmonary fibrosis because they are often demonstrated as consolidations on computed tomography. Case. A 68 year-old man was admitted to our hospital with a fever and a cough. The chest CT demonstrated honeycomb lung in the subpleural region of the both inferior lobes, suggesting pulmonary fibrosis. Consolidation was superimposed on the honeycombing in the right basal segment. Although the sputum cytology was suspicious of squamous cell carcinoma, the consolidation was diagnosed to be due to pneumonia complicated by pulmonary fibrosis because the carcinoma in situ of the larynx was detected, and the patient was treated with antibiotics. However, since it slightly increased in size after one month, the consolidation was suspected to be a neoplasm. Bronchoscopic lavage of right B9 and B10 revealed the squamous cell carcinoma. The consolidation in the right lower lobe was diagnosed as squamous cell carcinoma, and a right lower lobectomy was performed. Histological findings revealed that moderately differentiated squamous cell carcinoma formed a conglomerate scattered in the extensive fibrosis and there was parietal pleural invasion. It was classified as T3NOMO, stage IIB. Conclusion. When diagnosing lung carcinomas accompanied by pulmonary fibrosis on the CT, it is necessary to be aware that the morphologic findings are different from carcinoma which occurs in the normal lung.View full abstractDownload PDF (4028K) -
Koji Sakaguchi, Hirotoshi Horio, Katsuyuki Kuwahara2004 Volume 44 Issue 7 Pages 791-794
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Small bowel metastases from lung cancer are rare, and few operated cases have been described. We report 3 cases of small bowel metastasis from primary lung cancers followed by acute abdomen. Cases. Case 1 was a 64-year-old man who had undergone sleeve resection of the right upper lobe of the lung for large cell carcinoma of the lung. Two months later, he reported abdominal pain and ileus was suspected. Partial resection of the small bowel was performed. Pathological examination revealed lung cancer metastases. Case 2 was a 54-year-old man diagnosed with left lung cancer and metastases to the right tonsil. Chemoradiotherapywas performed. During the course of treatment, the patient complained of melena. Bleeding from the small bowel was suspected. Partial resection of the small bowel was performed. Pathological examination revealed metastases of large cell carcinoma. Case 3 was a 71-year-old man. Abdominal distension was noted during the course of whole body examinations for suspected lung cancer. Partial resection of the small bowel was performed based on a diagnosis of ileus. Pathological examination revealed metastases of undifferentiated lung carcinoma. Conclusion. Small bowel metastasesfrom lung cancer are rare and have poor prognoses. However, if a patient with lung cancer complains of abdominal symptoms and inflammatory disease can' t be denied, a laparotomy should be considered. A helical CT may be useful in making that decision.View full abstractDownload PDF (2997K) -
Minako Seki, Yasuto Jinn, Wenlin Du2004 Volume 44 Issue 7 Pages 795-799
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. In 1999, World Health Organization (WHO) published a new classification of thymic tumors. According to this classification, type A and AB thymomas are considered as benign tumors, because such cases show excellent prognosis. Most cases of type A or AB thymoma are in stage I or IIaccording to Masaoka's staging system, and extrathoracic metastasis is very rare in any histological types of thymoma. We reported a case of thymoma classified as type AB according to the WHO histological classification and in stage Wb by Masaoka's clinical staging. Case. A 71 years-old Japanese man admitted to our hospital for resection of a thymic tumor. He had been found to have an abnormal shadow in the mediastinum nine years before, but refused any medical treatment at that time. In the year 2000, he underwent craniotomy for brain tumor, which was diagnosed as metastatic thymoma. Then, he underwent total thymectomy with partial resection of the lung and removal of a metastatic lung tumor, the fmal diagnosis being type AB thymoma (WHO) with brain and multiple lung metastases (Stage IVb). Conclusion. This report deals with an extremely rare case of type AB thymoma with brain metastasis. It should be noticed that most of type AB thymoma behave as benign tumor, but distant metastasis may occur after a long lapse of time, though the growth is slow.View full abstractDownload PDF (4189K) -
2004 Volume 44 Issue 7 Pages 800-803
Published: December 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (772K)
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